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Pediatricians say they frequently are treating mental-health disorders in young patients, and
some are uncomfortable with that role.Hospitals say they are working to better integrate
mental-health training into residency programs, but for now, doctors often are expected to figure
it out themselves.

“I came out of training 17 or 18 years ago knowing everything about chemotherapy or heart
disease but not one thing about mental health,” said Dr. Brad Dickson of South West Pediatrics in
Grove City. “So I had to train on my own.”

At the same time, some pediatricians are referring patients to psychiatrists for mild
mental-health disorders when they could, ideally, treat the patient themselves, said Laura Moskow
Sigal, the executive director of Mental Health America of Franklin County.

“When you are dealing with kids, I think that doctors are more apprehensive in prescribing
medications, especially if they are not a psychiatrist,” she said. “People are much more concerned
when kids are involved.”

So why aren’t parents seeking child psychologists and psychiatrists? Some of it might have to do
with availability. It can take weeks or months to see a new doctor.“Parents have to be very
diligent, and if they feel like their child needs help right away, they should stress the
importance of that to whoever they speak with,” Moskow Sigal said.Pediatricians might have to
schedule a longer visit to talk about mental health. The typical pediatrician visit is about 10
minutes, Moskow Sigal said.

“Most doctors want to do a good job. And yet, increasingly, there’s this demand for productivity
and demand for volume,” said Dr. John Campo, the chairman of the psychiatry department at Ohio
State University. “It makes it very hard to do what you need to do.”To alleviate the time crunch,
some pediatricians say, they bring patients back at the end of the day or later that week to talk
more in-depth.People in the mental-health field are working on additional solutions to help
integrate mental health into primary care and deal with the shortage of child and adolescent
psychiatrists.

Nationwide Children’s Hospital recruited Campo in 2006 to develop a child and adolescent
psychiatry division. Since then, he has brought in 15 child and adolescent psychiatrists and helped
build a network of behavioral-health specialists who act as consultants.“(Pediatricians) can have
access to a child and adolescent psychiatrist by phone, by email and by tele-link,” Campo said. “If
they have a real-time question, they can pick up the phone or go online and request an informal
consult.”

This could cut down on the number of children and young adults who need to go outside the
primary-care setting to see a specialist.

“The psychiatrists I talk to wish the primary-care doctors were doing more and handling more of
the mental-health problems,” Dickson said.